1.New progress and challenges in the diagnosis and treatment of cosmetic allergy-related adverse reactions.
Chong ZHANG ; Shao Min ZHONG ; Yan WU ; Jia Hui ZHAO ; Zuo Tao ZHAO ; Yan TIAN ; Hang LI
Chinese Journal of Preventive Medicine 2023;57(4):591-596
In China, the current standard for cosmetic adverse reactions related skin disease (GB/T 17149.1-1997) was jointly issued by the Ministry of Health and the State Bureau of Technical Supervision in 1997, cosmetic-allergic adverse reactions include allergic contact dermatitis and photo-allergic contact dermatitis according to this standard. The increasing use and changes in cosmetic ingredients or formula lead to a significant increase for the incidence of adverse reactions as the cosmetics industry is developing rapidly in the last 20 years. In the meantime, the clinical manifestations have become more diverse. In recent years, there have been many reports on the special manifestations for cosmetic allergy and allergen test, which provide a reference for the subsequent improvement of the diagnosis and prevention.
Humans
;
Patch Tests/adverse effects*
;
Dermatitis, Allergic Contact/therapy*
;
Cosmetics/adverse effects*
;
China
;
Incidence
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Allergens/adverse effects*
2.Expert consensus on the prevention and treatment of adverse reactions in subcutaneous immunotherapy(2023, Chongqing).
Yu Cheng YANG ; Yang SHEN ; Xiang Dong WANG ; Yan JIANG ; Qian Hui QIU ; Jian LI ; Shao Qing YU ; Xia KE ; Feng LIU ; Yuan Teng XU ; Hong Fei LOU ; Hong Tian WANG ; Guo Dong YU ; Rui XU ; Juan MENG ; Cui Da MENG ; Na SUN ; Jian Jun CHEN ; Ming ZENG ; Zhi Hai XIE ; Yue Qi SUN ; Jun TANG ; Ke Qing ZHAO ; Wei Tian ZHANG ; Zhao Hui SHI ; Cheng Li XU ; Yan Li YANG ; Mei Ping LU ; Hui Ping YE ; Xin WEI ; Bin SUN ; Yun Fang AN ; Ya Nan SUN ; Yu Rong GU ; Tian Hong ZHANG ; Luo BA ; Qin Tai YANG ; Jing YE ; Yu XU ; Hua Bin LI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(7):643-656
3.Risk factors of systemic allergic reactions caused by subcutaneous allergen immunotherapy.
Li Sha LI ; Kai GUAN ; Jia YIN ; Liang Lu WANG ; Yu Xiang ZHI ; Jin Lü SUN ; Hong LI ; Li Ping WEN ; Rui TANG ; Jian Qing GU ; Zi Xi WANG ; Le CUI ; Ying Yang XU ; Sai Nan BIAN
Chinese Journal of Preventive Medicine 2023;57(12):1972-1977
Objective: To investigate the incidence and risk factors of systemic allergic reactions induced by subcutaneous immunotherapy (SCIT) in patients undergoing SCIT injections in Peking Union Medical College Hospital (PUMCH). Methods: This is a single center retrospective cohort study. Using the outpatient information system of PUMCH, the demographic information and injection-related reaction data of patients undergoing SCIT injection in Allergy Department of PUMCH from December 2018 to December 2022 were retrospectively analyzed to count the incidence and risk factors of systemic allergic reactions caused by SCIT. Mann-Whitney nonparametric test or chi-square test was used for single-factor analysis, and multiple logistic regression was used for multiple-factor analysis. Results: A total of 2 897 patients received 18 070 SCIT injections in Allergy Department during the four years, and 40 systemic allergic reactions occurred, with the overall incidence rate of 0.22%. The incidence of systemic allergic reaction was 0.37% when using imported dust mite preparation and 0.15% when using domestic multi-component allergen preparation. The risk factors significantly related with SCIT-induced systemic allergic reactions in patients using imported dust mite preparation were age less than 18 years old (OR=3.186,95%CI: 1.255-8.085), highest injection concentration (OR value could not be calculated because all patients with systemic reactions were injected with highest concentration), and large local reaction in previous injection (OR=22.264,95%CI: 8.205-60.411). The risk factors for SCIT-induced systemic allergic reactions in patients using domestic allergen preparation were 5 or more types of allergens (OR=3.455,95%CI: 1.147-10.402), highest injection concentration (OR=3.794,95%CI: 1.226-11.740) and large local reaction in previous injection (OR=63.577,95%CI: 22.248-181.683). However, SCIT injection in pollen allergic patients during the pollen season did not show a correlation with systemic allergic reaction. Conclusion: The incidence of SCIT-induced systemic allergic reactions was low in the Chinese patient population of this study. Patients with one or more risk factors, such as multiple allergen injection, highest injection concentration, large local reaction in previous injection, should be given high attention and vigilance against systemic allergic reactions.
Humans
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Allergens
;
Asian People
;
Desensitization, Immunologic/adverse effects*
;
Hypersensitivity/epidemiology*
;
Retrospective Studies
4.Risk factors of systemic allergic reactions caused by subcutaneous allergen immunotherapy.
Li Sha LI ; Kai GUAN ; Jia YIN ; Liang Lu WANG ; Yu Xiang ZHI ; Jin Lü SUN ; Hong LI ; Li Ping WEN ; Rui TANG ; Jian Qing GU ; Zi Xi WANG ; Le CUI ; Ying Yang XU ; Sai Nan BIAN
Chinese Journal of Preventive Medicine 2023;57(12):1972-1977
Objective: To investigate the incidence and risk factors of systemic allergic reactions induced by subcutaneous immunotherapy (SCIT) in patients undergoing SCIT injections in Peking Union Medical College Hospital (PUMCH). Methods: This is a single center retrospective cohort study. Using the outpatient information system of PUMCH, the demographic information and injection-related reaction data of patients undergoing SCIT injection in Allergy Department of PUMCH from December 2018 to December 2022 were retrospectively analyzed to count the incidence and risk factors of systemic allergic reactions caused by SCIT. Mann-Whitney nonparametric test or chi-square test was used for single-factor analysis, and multiple logistic regression was used for multiple-factor analysis. Results: A total of 2 897 patients received 18 070 SCIT injections in Allergy Department during the four years, and 40 systemic allergic reactions occurred, with the overall incidence rate of 0.22%. The incidence of systemic allergic reaction was 0.37% when using imported dust mite preparation and 0.15% when using domestic multi-component allergen preparation. The risk factors significantly related with SCIT-induced systemic allergic reactions in patients using imported dust mite preparation were age less than 18 years old (OR=3.186,95%CI: 1.255-8.085), highest injection concentration (OR value could not be calculated because all patients with systemic reactions were injected with highest concentration), and large local reaction in previous injection (OR=22.264,95%CI: 8.205-60.411). The risk factors for SCIT-induced systemic allergic reactions in patients using domestic allergen preparation were 5 or more types of allergens (OR=3.455,95%CI: 1.147-10.402), highest injection concentration (OR=3.794,95%CI: 1.226-11.740) and large local reaction in previous injection (OR=63.577,95%CI: 22.248-181.683). However, SCIT injection in pollen allergic patients during the pollen season did not show a correlation with systemic allergic reaction. Conclusion: The incidence of SCIT-induced systemic allergic reactions was low in the Chinese patient population of this study. Patients with one or more risk factors, such as multiple allergen injection, highest injection concentration, large local reaction in previous injection, should be given high attention and vigilance against systemic allergic reactions.
Humans
;
Allergens
;
Asian People
;
Desensitization, Immunologic/adverse effects*
;
Hypersensitivity/epidemiology*
;
Retrospective Studies
5.Screening of Shuanghuanglian Injection allergenic ingredients based on immune fingerprint.
Wen WEN ; Fu-Yuan HE ; Wen-Long LIU ; Yi-Qun ZHOU ; Hong-Yu LIU
China Journal of Chinese Materia Medica 2019;44(8):1588-1595
In this paper,immune fingerprint was used to screen the allergenic components of Shuanghuanglian Injection(SHLI) by enzyme-linked immuno sorbent assay(ELISA) combined with HPLC/MS method. ELISA-embedded anti-IgE antibody could successfully adsorb allergens in SHLI and its plasma samples containing drugs through different routes of administration,suggesting that SHLI can induce type I hypersensitivity in rats. HPLC fingerprints and MS map of SHLI and drug-containing plasma samples from different routes of administration before and after anti-IgE antibody adsorption were established. According to the similarity evaluation of HPLC fingerprints and analysis results MS map,the sensitization of traditional Chinese medicine injections can be changed by different administration methods. There were 22 kinds of components that can be adsorbed by specific anti-Ig E antibodies in Shuanghuanglian Injection and its drug-containing plasma,most of them were acids and nitrogen compounds. Based on supramolecular theory,it was inferred that these compounds came from SHLI or body,and may form supramolecular hapten,which results in immunotoxicity and allergic reaction when being used as injection instead of oral liquid. Immune fingerprint is not only used to screen out single component allergen,but also more comprehensive,sensitive and easy to operate. It can provide reference for the future research methods of allergic reaction of traditional Chinese medicine injections.
Allergens
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analysis
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Animals
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Chromatography, High Pressure Liquid
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Drugs, Chinese Herbal
;
adverse effects
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chemistry
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Enzyme-Linked Immunosorbent Assay
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Hypersensitivity
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Injections
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Medicine, Chinese Traditional
;
Rats
6.The clinical value of China Savin pollen extract used for skin prick test.
Kai GUAN ; J X ZHOU ; R Q WANG ; J YIN ; L L WANG ; Y X ZHI ; J L SUN ; H LI ; L P WEN ; J Q GU ; R TANG ; Z X WANG ; L S LI ; T XU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2018;32(3):161-166
The aim of this study is to evaluate the effectiveness and safety of China Savin pollen extract which was used for skin prick test (SPT) in the diagnosis of China Savin pollen allergy. Patients with diagnosis of allergic diseases were collected from Allergy Department of Peking Union Medical College Hospital. All patients were given SPT with China Savin pollen extract, and the mean wheal diameter (MWD) was measured after 15 minutes. Receiver operating characteristic curve (ROC) analysis was performed based on the results of serum specific immunoglobulin E (sIgE). The effectiveness of SPT in the diagnosis of China Savin pollen allergy was evaluated under different diagnostic cutoff values. Adverse events were also recorded to evaluate the safety. A total of 1 029 patients were enrolled in this study without drop out case. There were 1 007 patients in full analysis set (FAS) and 765 patients in per protocol analysis set (PPS). The elimination rate was 25.66%. The area under the ROC curve of FAS is 0.814 (95%: 0.788-0.839); which of PPS is 0.829 (95%: 0.801-0.857). Based on the ROC curve of PPS, the optimal and the 95% specificity diagnostic cutoff values of MWD were 3.25 mm and 4.75 mm respectively. Based on different diagnostic cutoff value (3.00, 3.25 and 4.75 mm), the sensitivities of SPT with China Savin pollen extract were 0.740 0 (95%: 0.701 6-0.778 4), 0.700 (95%: 0.659 8-0.740 2) and 0.532 (95%: 0.488 3-0.575 7) respectively, whereas the specificity was gradually increased in sequence, which was 0.769 8 (95%: 0.719 1-0.820 5), 0.826 4 (95%: 0.780 8-0.872 0) and 0.950 9 (95%: 0.924 9-0.976 9) respectively. There were 7 adverse events observed among 6 patients (rate: 0.583%, 6/1 029). The manifestation was mild. There was no severe adverse event. SPT with China Savin pollen extract is an effective and safe tool for the diagnosis of China Savin pollen allergy. The effectiveness of diagnosis could be improved based on integration of medical history and different diagnostic threshold values of SPT.
Allergens
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adverse effects
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China
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Humans
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Immunoglobulin E
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Pollen
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adverse effects
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Rhinitis, Allergic, Seasonal
;
diagnosis
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Skin Tests
7.Experimental study of suspicious sensitization component screening on Huachansu injection.
Ying XIAO ; Yu-Bin ZHAO ; Yan-Ming XIE
China Journal of Chinese Materia Medica 2012;37(18):2824-2827
OBJECTIVETo explore a new experimental method for screening of allergens in post-market traditional Chinese medicine injections by confirming allergens in Huachansu injection.
METHODFirst of all, the serum of patients allergic to Huachansu injection were collected, at the same time, the dubious allergen was conjugated to bovine serum albumin (BSA) by EDC coupling procedure to form complete antigen (BNP-BSA), which makes it possible to reproduce the allergic reaction of Huachansu injection in vitro. The histamine liberation ratio, the level of TNF-alpha and Histamine released from RBL-2H3 mast cell were detected; the above data were compared with those obtained in vivo.
RESULTThe difference of the histamine liberation ratio, the levels of TNF-alpha and histamine of the resibufogenin-BSA group, group of patients allergic to Huachansu injection were not significant compared with those of normal control group. However, there were significant difference in those data among the cinobufagin-BSA group, the blank control and normal control group (P<0.05).
CONCLUSIONThe allergen in the serum collected from patients allergic to Huachansu injection is resibufogenin.
Allergens ; adverse effects ; immunology ; Amphibian Venoms ; adverse effects ; immunology ; Animals ; Anura ; Bufanolides ; adverse effects ; immunology ; Drug Hypersensitivity ; immunology ; Histamine Release ; Humans ; Mast Cells ; immunology ; Medicine, Chinese Traditional
8.Study on allergenicity of chlorogenic acid in Qingkailing injection.
Zhiguo WANG ; Danqiao WANG ; Youhua YU ; Yu SUI ; Haifeng CUI ; Meiyu ZHANG
China Journal of Chinese Materia Medica 2011;36(14):1870-1873
OBJECTIVETo observe the allergenicity of chlorogenic acid (CA) in Qingkailing injection.
METHODCA was administrated to Beagle dogs through intravenous injection, and on experimental allergic sensitization of guinea pigs, it was through intraperitoneal and intravenous injection. The behavioral changes of Beagle dogs and guinea pigs were observed, and changes of the content of histamine, IgE, IgG, IgM, ECP and IL-4 in blood were detected. Then the allergenicity of CA was determined by experimental anaphylactoid and allergic methods.
RESULTThere were no typical behavioral changes and increasement of the content of histamine, IgE, IgG, IgM, ECP and IL-4 in blood.
CONCLUSIONCA can not provoke anaphylactoid and allergic reactions.
Allergens ; adverse effects ; Animals ; Behavior, Animal ; drug effects ; Chlorogenic Acid ; adverse effects ; Dogs ; Drug Hypersensitivity ; blood ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Female ; Guinea Pigs ; Injections ; Male
9.Review of research approach on allergens of Shuanghuanglian injection and its important research strategy of susceptibility gene.
Yubin ZHAO ; Ying XIAO ; Yanming XIE ; Yuanyuan LI
China Journal of Chinese Materia Medica 2011;36(8):1106-1108
Reviewing the progress on study about the major allergen of Shuanghuanglian injection in recent years, resulted in that individual differences of anaphylactic shock are closely related with HLA gene polymorphism. Basing on this, we put forward the research strategy on susceptibility gene of important allergen of Shuanghuanglian injection based on the theory of genetic fingerprints, in order to make sure about the relationship the major allergen of Shuanghuanglian injection and HLA-DRB gene polymorphism and specificity IgE antibody, and to clarify the allergic reaction loci reduced allergic reactions, which can provide the reference data for the study on mechanisms for anaphylactic reaction of Shuanghuanglian injection, and research ideas for the sensitization mechanism of traditional Chinese medicine injection study.
Allergens
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adverse effects
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Anaphylaxis
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chemically induced
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genetics
;
immunology
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Drugs, Chinese Herbal
;
adverse effects
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Genetic Predisposition to Disease
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genetics
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HLA-DR Antigens
;
genetics
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HLA-DRB1 Chains
;
Humans
;
Immunoglobulin E
;
immunology
;
Injections
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Polymorphism, Genetic
;
genetics
10.Strategy of individualized screening of allergens in serum of patients allergic to Shuanghuanglian injection based on RBL-2H3 mast cell model.
Ying XIAO ; Yubin ZHAO ; Yanming XIE
China Journal of Chinese Materia Medica 2011;36(20):2799-2802
Screening of allergens in Shuanghuanglian injection is now one of the key and urgently solved problems in assessment on the safety of traditional Chinese medicine injections. In this paper, the author reviewed the improtant progresses in study on Screening of allergens in shuanghuanglian injection. The principle, concrete methods and specific procedure were discussed on the strategy of individualized screening of allergens in serum of patients allergic to Shuanghuanglian injection based on RBL-2H3 mast cell model.
Allergens
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blood
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Animals
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Cells, Cultured
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Drug Hypersensitivity
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diagnosis
;
Drugs, Chinese Herbal
;
adverse effects
;
Humans
;
Injections
;
Mast Cells
;
drug effects
;
Rats
;
Rats, Wistar

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